| NPI | 1699039586 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: MO 2015029485) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MO 2015029485) |
| Enumeration Date | 2012-06-26 |
| Last Update Date | 2021-11-15 |